The London Spine Unit : most established spine centre in London
Published article
BACKGROUND: Accounting for less than 0.4% of disc herniations, intradural lumbar disc herniations (ILDHs) are a rare occurrence primarily described as a complication after lumbar spine surgery. It is speculated that the herniation may propagate intradurally from either an unrecognized dural defect after initial surgery or as a result of adhesions between the dura and posterior longitudinal ligament. This report explores the etiology, presentation, diagnostic evaluation, and treatment of ILDH…
Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
J Neurosurg Case Lessons. 2021 Nov 1;2(18):CASE21336. doi: 10.3171/CASE21336. eCollection 2021 Nov 1.
ABSTRACT
BACKGROUND: Accounting for less than 0.4% of disc herniations, intradural lumbar disc herniations (ILDHs) are a rare occurrence primarily described as a complication after lumbar spine surgery. It is speculated that the herniation may propagate intradurally from either an unrecognized dural defect after initial surgery or as a result of adhesions between the dura and posterior longitudinal ligament. This report explores the etiology, presentation, diagnostic evaluation, and treatment of ILDH along with a case report and microsurgery video.
OBSERVATIONS: A 67-year-old patient who 1 year earlier had undergone an L2-5 laminectomy and L2-3 decompression with no known complications presented with low back pain and radiating right leg, buttock, and groin pain for 1 month. Physical examination indicated no numbness or weakness. Magnetic resonance imaging demonstrated a large ILDH. A transforaminal interbody fusion was performed followed by a durotomy, ILDH removal, and dural closure. A ventral dural defect was found and repaired during the procedure.
LESSONS: The treatment for ILDH is laminectomy with dorsal durotomy. Because ILDH has rarely been described in literature, understanding its presentation is crucial for prompt identification and management.
PMID:36061623 | PMC:PMC9435552 | DOI:10.3171/CASE21336
The London Spine Unit : most established spine centre in London
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